ON A ROLL: A TRIP TOWARDS APPROVING PSYCHEDELICS AS PSYCHOTHERAPEUTIC ADJUNCTS

Abstract

Two decades after research on psychedelics in human subjects stopped due to unfavorable public opinion and political outcry, a few studies reappeared on the scene—at first, these studies focused on safety and the substances’ psychopharmacological effects, but soon researchers also began investigating their clinical uses in the treatment of substance addiction, cancer anxiety, and posttraumatic stress disorder. The re-establishment of research in this field has created a policy window, an opportunity for psychedelics to enter medical practice and move out of Schedule I. This thesis aims to answer how such a policy window arose and discuss the implications such a window may have for future policy changes. This work uses John W. Kingdon’s Multiple Streams Framework to elucidate the re-emergence of research. Kingdon’s framework states that policy opportunities arise from the confluence of a problem, feasible policy options, and political assent. I argue that, while political factors are the most conspicuous of the three and have therefore been discussed in most detail elsewhere, salient changes in all three were necessary for the window to open. In the problem stream, the creation of private organizations by policy entrepreneurs first generated the sentiment that psychedelics should be approved for prescription use due to their interesting pharmacological effects; without such a push, no opening for change would exist. Furthermore, the proposal to introduce psychedelics to medicine has been perceived as feasible by stakeholders, including the greater medical community. Finally, changing political pressures on and within the FDA and drug control bodies have signaled federal willingness to reconsider the status of psychedelics in the United States. In closing, this work projects how the streams may shift over the next few years to either act on the policy window or close it. I argue that while the field is riding a wave of optimism, public perception of the issue diverges sharply from that of psychedelic advocates. To avoid backlash, it will be vital for advocates to closely link the drugs to the psychiatric indications that they are seeking to treat and gain acceptance within those health communities.